Mechanisms of Listening Effort in School Age Children who are Hard of Hearing

学龄听力障碍儿童的听力努力机制

• 批准号: 9502268
• 负责人: Elizabeth A. Walker
• 金额: $ 15.25万
• 依托单位: UNIVERSITY OF IOWA
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-07-01 至 2020-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9502268
• 关键词: Acoustics; Address; Adult; Affect; Age; Auditory; Child; Childhood; Clinical; Clinical Management; Cognition; Cognitive; Communication; Complex; Cueing for speech; Data; Development; Devices; Dimensions; Early Intervention; Environment; Evidence based intervention; Evidence based practice; Goals; Hearing; Hearing Aids; Income; Individual Differences; Knowledge; Learning; Linguistics; Literature; Measures; Mission; Noise; Patient Self-Report; Performance; Policies; Population Intervention; Process; Psyche structure; Public Health; Reaction Time; Reporting; Research; Research Proposals; Resources; Role; School-Age Population; Schools; Short-Term Memory; Signal Transduction; Speech; Testing; Theoretical model; United States National Institutes of Health; Variant; Vocabulary; Work; base; cognitive load; cognitive skill; early childhood; effective intervention; experience; hearing impairment; insight; multitask; programs; skills; social; sound; speech recognition; theories

1 ABSTRACT 2 Many children with mild to severe hearing loss are identified and receive early intervention at very young ages. 3 Even with this early intervention, however, children who are hard of hearing (CHH) experience challenges with 4 communication due to reduced access to the auditory signal. These challenges are further compounded in 5 school because CHH have increased difficulty perceiving speech in adverse acoustic conditions and most 6 listening conditions are characterized by poor acoustics. When listening in adverse conditions, CHH must exert 7 additional cognitive resources compared to children with normal hearing (CNH) in order to perceive an incoming 8 message. Consequently, they have fewer cognitive resources available to perform additional tasks and must 9 expend increased listening effort. Listening effort requires the coordination of low-level, bottom-up processes, 10 and higher-level, top-down processes. There is a lack of evidence regarding the interplay between auditory 11 access and higher-level cognitive skills in influencing individual differences in listening effort for CHH. This 12 knowledge gap hinders the understanding of the underlying mechanisms that drive listening effort in children 13 with hearing loss, which in turn, limits the ability to develop evidence-based interventions for this population. The 14 current proposal seeks to determine the factors that underlie increased listening effort in school-age CHH. This 15 proposal is based on a limited resources capacity theory, which posits that listeners require additional cognitive 16 resources to maintain optimal listening performance during adverse acoustic conditions, and this demand on 17 resources results in a decline in performance on secondary tasks. Specifically, the current proposal tests the 18 hypothesis that top-down processing, quantified by working memory and linguistic skills, is associated with 19 listening effort in school-age CHH, and this relationship is moderated by bottom-up processing, measured via 20 aided audibility. Two specific aims are proposed to test this hypothesis: Aim 1. To determine the effect of higher- 21 level cognitive-linguistic skills on listening effort in school-age children who are hard of hearing, and to evaluate 22 the extent to which auditory access influences the relationship between cognitive-linguistic skills and listening 23 effort. Aim 2. To identify the effects of hearing aid use and background noise on listening effort in children who 24 are hard of hearing. In Aim 1, working memory capacity, receptive vocabulary, and aided speech audibility will 25 be used to predict listening effort in varying levels of background noise. In Aim 2, listening effort for CHH will be 26 evaluated in aided and unaided conditions, in quiet and in background noise. In both aims, different dimensions 27 of listening effort will be captured, including reaction time, self-report measures, and speech recognition 28 performance. The data generated from this proposal will inform theoretical models regarding the integration of 29 low-level, acoustic-phonetic input and higher-level, cognitive-linguistic processes involved in listening, using a 30 mechanistic approach to examine listening effort. The proposed study will also provide empirical evidence for the 31 development of effective interventions for children with hearing loss, in both classroom and social settings.

1摘要 2许多患有轻度至重度听力损失的儿童被发现并在很小的年龄接受早期干预。 3然而，即使在这种早期干预的情况下，也很难听力的孩子（CHH）经历挑战 4由于访问听觉信号的访问降低而引起的通信。这些挑战进一步加剧了 5学校，因为CHH在不利的声学条件下感知语音的困难增加了 6聆听条件的特征是声学差。在不利条件下聆听时，CHH必须施加 与正常听力（CNH）的儿童相比，其他7个额外的认知资源，以感知传入 8消息。因此，它们具有更少的认知资源来执行其他任务，必须 9支出增加了听力。听力工作需要低级，自下而上的过程的协调， 10和更高级别的自上而下的过程。关于听觉之间的相互作用缺乏证据 11访问和高级认知能力在影响CHH的听力工作中的个体差异方面。这 12知识差距阻碍了对儿童听力努力的基本机制的理解 13听力损失又限制了为该人群制定基于证据的干预措施的能力。这 14当前的提议旨在确定在学龄CHH中增加听力努力的因素。这 15提案基于有限的资源能力理论，该理论认为听众需要额外的认知 16资源以保持在不良声条件下的最佳听力表现，这对 17资源导致次要任务的性能下降。具体而言，当前的提案测试了 18假设自上而下的处理（通过工作记忆和语言技能量化）与 19学龄CHH的听力工作，这种关系通过自下而上的处理来调节，通过 20辅助可听性。提出了两个具体目的来检验这一假设：目的1。确定较高的影响 21级水平的认知语言技能在听力努力并评估的学龄儿童中 22听觉访问影响认知语言技能与聆听之间的关系程度 23努力。目标2。确定助听器使用和背景噪音对儿童听力工作的影响 24个很难听。在AIM 1中，工作记忆能力，接受词汇和辅助语音可听性将 25可用于预测不同级别的背景噪声中的听力工作。在AIM 2中，CHH的听力努力将是 26在安静和背景噪声中在辅助和独立的条件下进行评估。在两个目标中，不同的维度 27的听力工作将被捕获，包括反应时间，自我报告措施和语音识别 28性能。该提案产生的数据将为理论模型提供有关集成的理论模型 29低级，声学输入和更高级别的认知语言过程 30个检查听力工作的机械方法。拟议的研究还将为 31在课堂和社会环境中，为有听力损失的儿童开发有效的干预措施。